Table 2.

Major Data Themes in Clinician Responses to Survey

Total Number of RespondentsTotal Positive Responses, n (%)
1. Many barriers exist to the treatment of CNCP, including many uncertainties in optimal management
    Behavioral health care not financially accessible to CNCP patients* (% yes)426199 (47%)
    Substance abuse counselor not financially accessible to CNCP patients* (% yes)421143 (34%)
    Pain specialist not financially accessible to CNCP patients* (% yes)422172 (41%)
    Complementary/alternative medicine providers (e.g., acupuncture, herbalists) not financially accessible to CNCP patients* (% yes)421190 (45%)
    Need for more CNCP continuing medical education (% agree/strongly agree)468204 (44%)
    Long-acting opioids are over-utilized for many CNCP patients in my community (% agree/strongly agree)489212 (43%)
    Long-acting opioids are under-utilized for many CNCP patients in my community (% agree/strongly agree)489152 (31%)
2. For many patients, CNCP is a complex biopsychosocial condition for which a multidisciplinary approach is needed
    Experience discomfort in managing CNCP because of: (% some/moderate/much discomfort)
        Patient behavioral health issues*400383 (96%)
        Lack of a defined mechanism of pain*406371 (91%)
        Lack of full work-up for cause of pain*406377 (93%)
    Observe common reasons for uncontrolled pain in CNCP patients: (% agree/strongly agree)
        Depression, anxiety, other mental health disorders469439 (94%)
        Alcohol or other substance use disorders467354 (76%)
        Poor coping skills for pain469402 (86%)
        Poor coping skills for other life stressors*401371 (93%)
    Use massage therapy (% ever used)486379 (78%)
    Use acupuncture (% ever used)486354 (73%)
    Find cognitive behavioral therapy helpful (% somewhat/very helpful)490330 (67%)
    Find biofeedback, meditation, or relaxation therapy helpful (% somewhat/very helpful)491306 (62%)
3. Prescription opioid abuse is a serious problem
    Report patients ever divert opioids (% yes)489341 (70%)
    Report having had patients with severe adverse event due to CNCP opioid use (unintentional life-threatening event or death, or suicide) (% yes)489161 (33%)
    Prescribing opioids limited by (% sometimes/frequently)
        Concern over opioid side effects*412329 (80%)
        Concern over development of dependence*415292 (70%)
        Concern over development of addiction*415356 (86%)
        Concern over malingering/secondary gain*416320 (77%)
    Prescribe long-acting opioids
        No48475 (15%)
        Don't initiate but continue Rx prescribed by others48480 (17%)
        Initiate and continue484329 (68%)
4. Significant effort is required to properly assess for efficacy, side effects, and aberrant drug related behavior related to chronic opioid treatment
    Report burden to self in managing CNCP (% fair/large/biggest burden)497400 (80%)
    Report burden to practice in managing CNCP (% fair/large/biggest burden)496436 (88%)
    Report being “troubled” prescribing long-acting opioids for: (% yes)
        Chronic neck/back pain without defined mechanism*400236 (59%)
        Chronic headaches*400238 (60%)
        Chronic pelvic pain*400201 (50%)
        Chronic abdominal pain*400221 (55%)
    Use practice systems for CNCP management: (% yes)
        Use controlled substance agreements472407 (86%)
        Use urine drug screens470307 (65%)
        Use CNCP monitoring tool474104 (22%)
5. Perceived benefits of opioids to some patients and commitment to their patients influences clinicians to continue
    View CNCP as important clinical problem (% agree/strongly agree)495471 (95%)
    Concerned about poor quality of life for CNCP patients due to pain* (% agree/strongly agree)414401 (97%)
    Concerned that many CNCP patients receive inadequate pain control* (% agree/strongly agree)412266 (65%)
    Concerned about uncontrolled pain due to lack of access to resources (% agree/strongly agree)469343 (73%)
    Report benefit from patient education (e.g., handouts, web links) (% yes)493359 (73%)
    Report some CNCP patients benefit from opioid treatment* (% yes)405316 (78%)
  • * Question included on long-form version of survey only.

  • Number of respondents does not match total sample because of missing data.

  • CNPC, chronic non-cancer pain.